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To better understand the current challenges surrounding the use of artificial intelligence (AI) in K-12 schools, a team of researchers (Raffaella Borasi, David E. Miller, Patricia Vaughan-Brogan, Karen DeAngelis, Yu Jung Han, and Sharon Mason) interviewed 36 western New York school leaders in late 2023. Their concerns moved beyond potential cheating, as they instead identified four main priorities: receiving guidance to inform their decisions about AI, empowering all stakeholders to better understand AI and its implications, capitalizing on AI to support the work of teachers and staff, and enabling better technology solutions. These should inform future interventions aiming at leveraging AI in K-12 education.

Private school leaders weigh costs and benefits when deciding whether to participate in school voucher programs. Regulatory costs associated with accepting voucher funding could reduce private school leaders' willingness to participate. We test this hypothesis through the first random assignment analysis of the effects of various regulations on the expressed willingness of private school leaders to participate in hypothetical voucher programs that draws upon national data. We randomly assign different regulations to U.S. private school leaders and ask them whether they would participate in a hypothetical school voucher program during the following school year. Relative to no regulations, we find that open-enrollment mandates reduce the likelihood that private school leaders report being certain to participate in a hypothetical choice program by about 14 percentage points, or 67%. The requirement that private schools accept the voucher funding amount as payment-in-full reduces the likelihood that private school leaders report being certain to participate by 16 percentage points, or 77%. Some regulations are more likely to deter private schools with higher reported tuitions, higher enrollment trends, more specialization, and more climate problems.

Climate change jeopardizes human health, global biodiversity, and sustainability of the biosphere. To make reliable predictions about climate change, scientists use Earth system models (ESMs) that integrate physical, chemical, and biological processes occurring on land, the oceans, and the atmosphere. Although critical for catalyzing coupled biogeochemical processes, microorganisms have traditionally been left out of ESMs. Here, we generate a "top 10" list of priorities, opportunities, and challenges for the explicit integration of microorganisms into ESMs. We discuss the need for coarse-graining microbial information into functionally relevant categories, as well as the capacity for microorganisms to rapidly evolve in response to climate-change drivers. Microbiologists are uniquely positioned to collect novel and valuable information necessary for next-generation ESMs, but this requires data harmonization and transdisciplinary collaboration to effectively guide adaptation strategies and mitigation policy.

Soil carbon loss is likely to increase due to climate warming, but microbiomes and microenvironments may dampen this effect. In a 30-year warming experiment, physical protection within soil aggregates affected the thermal responses of soil microbiomes and carbon dynamics. In this study, we combined metagenomic analysis with physical characterization of soil aggregates to explore mechanisms by which microbial communities respond to climate warming across different soil microenvironments. Long-term warming decreased the relative abundances of genes involved in degrading labile compounds (e.g. cellulose), but increased those genes involved in degrading recalcitrant compounds (e.g. lignin) across aggregate sizes. These changes were observed in most phyla of bacteria, especially for Acidobacteria, Actinobacteria, Bacteroidetes, Chloroflexi, and Planctomycetes. Microbial community composition was considerably altered by warming, leading to declined diversity for bacteria and fungi but not for archaea. Microbial functional genes, diversity, and community composition differed between macroaggregates and microaggregates, indicating the essential role of physical protection in controlling microbial community dynamics. Our findings suggest that microbes have the capacity to employ various strategies to acclimate or adapt to climate change (e.g. warming, heat stress) by shifting functional gene abundances and community structures in varying microenvironments, as regulated by soil physical protection.

Passive acoustic monitoring is an essential tool for studying beaked whale populations. This approach can monitor elusive and pelagic species, but the volume of data it generates has overwhelmed researchers ability to quantify species occurrence for effective conservation and management efforts. Automation of data processing is crucial, and machine learning algorithms can rapidly identify species using their sounds. Beaked whale acoustic events, often infrequent and ephemeral, can be missed when co-occurring with signals of more abundant, and acoustically active species that dominate acoustic recordings. Prior efforts on large-scale classification of beaked whale signals with deep neural networks (DNNs) have approached the class as one of many classes, including other odontocete species and anthropogenic signals. That approach tends to miss ephemeral events in favor of more common and dominant classes. Here, we describe a DNN method for improved classification of beaked whale species using an extensive dataset from the western North Atlantic. We demonstrate that by training a DNN to focus on the taxonomic family of beaked whales, ephemeral events were correctly and efficiently identified to species, even with few echolocation clicks. By retrieving ephemeral events, this method can support improved estimation of beaked whale occurrence in regions of high odontocete acoustic activity.

We conducted a genome-wide association study (GWAS) in a multiethnic cohort of 920 at-risk infants for retinopathy of prematurity (ROP), a major cause of childhood blindness, identifying 1 locus at genome-wide significance level (p

Abstract Retinitis Pigmentosa is a leading cause of severe vision loss. Retinitis Pigmentosa can present with a broad range of phenotypes impacted by disease age of onset, severity, and progression. This variation is influenced both by different gene mutations as well as unique variants within the same gene. Mutations in the nuclear hormone receptor 2 family e, member 3 are associated with several forms of retinal degeneration, including Retinitis Pigmentosa. In our previous studies we demonstrated that subretinal administration of one Nr2e3 dose attenuated retinal degeneration in rd7 mice for at least 3 months. Here we expand the studies to evaluate the efficacy and longitudinal impact of the NR2E3 therapeutic by examining three different doses administered at early or intermediate stages of retinal degeneration in the rd7 mice. Our study revealed retinal morphology was significantly improved 6 months post for all doses in the early-stage treatment groups and for the low and mid doses in the intermediate stage treatment groups. Similarly, photoreceptor function was significantly improved in the early stage for all doses and intermediate stage low and mid dose groups 6 months post treatment. This study demonstrated efficacy in multiple doses of NR2E3 therapy.

Abstract Background Understanding how the COVID-19 pandemic evolved under control measures is crucial to tackle the SARS-CoV-2 virus spread. Laos, a country bordering China but with late occurrence and low burden of COVID-19 compared to its neighbouring countries, was used for a case study. Methods A transmission model with disease reporting was proposed to investigate the impact of control measures on the SARS-CoV-2 virus spread in Laos from April 2021 to May 2022. It was assumed that the transmission rate changed with people’s behaviours, control measures and emerging variants; susceptibility decreased with vaccination and infection. Bayesian inference was used for model calibration to data of confirmed cases, deaths, and recoveries, and the deviance information criterion was used to select the best model variant. Results Our model including Non-pharmaceutical interventions (NPIs), behaviour change, vaccination, and changing variants well explained the three waves in Laos. The Alpha variant was estimated to have a basic reproduction number of 1.55 (95% CrI: 1.47–1.64) and was replaced by the Delta variant from September 2021 which was 1.88 (95% CrI: 1.77–2.01) times more transmissible; the Delta variant was replaced by Omicron variant from March 2022 which was 3.33 (95% CrI: 2.84–3.74) times more transmissible. The Delta variant was the most severe with a case fatality rate of 1.05% (95% CrI: 0.96–1.15%) while the Alpha variant and Omicron variant were much milder. The ascertainment rate was low and variable: first decreasing from 13.2 to 1.8% by 23 May 2021, and then increasing to 23.4% by 15 March 2022. Counterfactual simulations indicated that vaccination played strong roles in reducing infections even under the emergence of immune escape variants while behaviour change delayed but might not flatten the peak of outbreaks. Conclusions The three waves of Laos’ epidemics were due to the invasion of more transmissible and immune escape variants that affected the herd immunity built via vaccination and infection. Even with immunity waning and the escape of new variants, vaccination was still the major contributor to control COVID-19 and combining behaviour changes and vaccination would best suppress future outbreaks of COVID-19.

Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy.

BACKGROUND: Diaphragmatic hernia (DH) presenting acutely can be a potentially life-threatening condition. Its management continues to be debatable. METHODS: A bibliographic search using major databases was performed using the terms emergency surgery diaphragmatic hernia, traumatic diaphragmatic rupture and congenital diaphragmatic hernia. GRADE methodology was used to evaluate the evidence and give recommendations. RESULTS: CT scan of the chest and abdomen is the diagnostic gold standard to evaluate complicated DH. Appropriate preoperative assessment and prompt surgical intervention are important for a clinical success. Complicated DH repair is best performed via the use of biological and bioabsorbable meshes which have proven to reduce recurrence. The laparoscopic approach is the preferred technique in hemodynamically stable patients without significant comorbidities because it facilitates early diagnosis of small diaphragmatic injuries from traumatic wounds in the thoraco-abdominal area and reduces postoperative complications. Open surgery should be reserved for situations when skills and equipment for laparoscopy are not available, where exploratory laparotomy is needed, or if the patient is hemodynamically unstable. Damage Control Surgery is an option in the management of critical and unstable patients. CONCLUSIONS: Complicated diaphragmatic hernia is a rare life-threatening condition. CT scan of the chest and abdomen is the gold standard for diagnosing the diaphragmatic hernia. Laparoscopic repair is the best treatment option for stable patients with complicated diaphragmatic hernias. Open repair is considered necessary in majority of unstable patients in whom Damage Control Surgery can be life-saving.

Many countries are facing an aging population. As people live longer, surgeons face the prospect of operating on increasingly older patients. Traditional teaching is that with older age, these patients face an increased risk of mortality and morbidity, even to a level deemed too prohibitive for surgery. However, this is not always true. An active 90-year-old patient can be much fitter than an overweight, sedentary 65-year-old patient with comorbidities. Recent literature shows that frailty-an age-related cumulative decline in multiple physiological systems, is therefore a better predictor of mortality and morbidity than chronological age alone. Despite recognition of frailty as an important tool in identifying vulnerable surgical patients, many surgeons still shun objective tools. The aim of this position paper was to perform a review of the existing literature and to provide recommendations on emergency laparotomy and in frail patients. This position paper was reviewed by an international expert panel composed of 37 experts who were asked to critically revise the manuscript and position statements. The position paper was conducted according to the WSES methodology. We shall present the derived statements upon which a consensus was reached, specifying the quality of the supporting evidence and suggesting future research directions.

Abstract Early life adversity (ELA) is associated with earlier initiation and maintenance of tobacco smoking and with a greater risk of subsequent relapse. There is growing evidence that appetite hormones, including peptide YY (PYY), which modulates craving and satiety responses, play a role in stress and addiction processes. This study employed a quasi‐experimental design to examine the association between ELA and circulating PYY stress responses in smokers and nonsmokers (N = 152, ages 19–73 years) to examine the effects of nicotine addiction. Smokers initiated a quit attempt as part of the study and were classified as either abstinent smokers or relapsed smokers based on their nicotine use during the follow‐up period. PYY levels were measured at five timepoints during three lab sessions and compared between nonsmokers and the two smoking groups (abstainers, relapsers): while smokers were using nicotine ad libitum, 24 h after smokers initiated a quit attempt, and 4 weeks after smokers initiated a quit attempt. Multivariate analyses showed the main effects of time on PYY, which decreased over time within each session. The main effects of ELA during the first (ad libitum smoking) and second (24‐h post‐cessation for smokers) sessions indicated that experiencing ELA was associated with lower PYY. No systematic effect of nicotine addiction or relapse was observed in this study. These findings suggest that adults with higher ELA may experience lower PYY. Additional research is needed to further explore the role of PYY in stress and addiction processes.

β-Ga2O3 has received widespread attention due to its ultrawide bandgap, which potentially permits applications in extreme conditions. Ultrafast laser irradiation of β-Ga2O3 provides a means for exploring the response of the material under such conditions, which could result in the generation of point defects as well as a localized modification of structural features that could yield properties that differ from the pristine surface. However, an understanding of defects generated by femtosecond laser irradiation in the vicinity of laser-induced periodic surface structures (LIPSS) remains to be explored. We correlate topographic features with optical and electronic properties by combining near-nm scale resolution cathodoluminescence with Kelvin probe force microscopy. Defects are found to correlate with crystalline order and near-surface morphology, as well as changes in work function. They are also suggested to be closely related to the formation of high spatial frequency LIPSS. These results suggest a need for precise tuning of laser irradiation conditions as well as possible post-processing to control defects in future Ga2O3 devices. [ABSTRACT FROM AUTHOR]

β-Ga2O3 has received widespread attention due to its ultrawide bandgap, which potentially permits applications in extreme conditions. Ultrafast laser irradiation of β-Ga2O3 provides a means for exploring the response of the material under such conditions, which could result in the generation of point defects as well as a localized modification of structural features that could yield properties that differ from the pristine surface. However, an understanding of defects generated by femtosecond laser irradiation in the vicinity of laser-induced periodic surface structures (LIPSS) remains to be explored. We correlate topographic features with optical and electronic properties by combining near-nm scale resolution cathodoluminescence with Kelvin probe force microscopy. Defects are found to correlate with crystalline order and near-surface morphology, as well as changes in work function. They are also suggested to be closely related to the formation of high spatial frequency LIPSS. These results suggest a need for precise tuning of laser irradiation conditions as well as possible post-processing to control defects in future Ga2O3 devices. [ABSTRACT FROM AUTHOR]

Microbes are responsible for cycling carbon (C) through soils, and predicted changes in soil C stocks under climate change are highly sensitive to shifts in the mechanisms assumed to control the microbial physiological response to warming. Two mechanisms have been suggested to explain the long-term warming impact on microbial physiology: microbial thermal acclimation and changes in the quantity and quality of substrates available for microbial metabolism. Yet studies disentangling these two mechanisms are lacking. To resolve the drivers of changes in microbial physiology in response to long-term warming, we sampled soils from 13- and 28-year-old soil warming experiments in different seasons. We performed short-term laboratory incubations across a range of temperatures to measure the relationships between temperature sensitivity of physiology (growth, respiration, carbon use efficiency, and extracellular enzyme activity) and the chemical composition of soil organic matter. We observed apparent thermal acclimation of microbial respiration, but only in summer, when warming had exacerbated the seasonally-induced, already small dissolved organic matter pools. Irrespective of warming, greater quantity and quality of soil carbon increased the extracellular enzymatic pool and its temperature sensitivity. We propose that fresh litter input into the system seasonally cancels apparent thermal acclimation of C-cycling processes to decadal warming. Our findings reveal that long-term warming has indirectly affected microbial physiology via reduced C availability in this system, implying that earth system models including these negative feedbacks may be best suited to describe long-term warming effects on these soils.

Finding pathways to success for students with disabilities is important to the work of administrators and educators who wish to support this population. Guided by an anti-deficit framework and the minority group model, data from the 2015 and 2016 administration of the National Survey of Student Engagement were examined to learn how Engagement Indicators related to outcomes (GPA, satisfaction, and self-reported learning) for over fifteen thousand first-year students with disabilities. To avoid deficit framing, structural equation modeling was employed to measure the mediation effects of four Engagement Indicators for students with learning disabilities compared to other students with disabilities. Results from this study indicate that most Engagement Indicators are significantly, and in some cases strongly, related to outcomes for students with disabilities; however, only Student-Faculty Interaction was a significant, positive mediator for students with learning disabilities whereas the significant negative mediators indicate that engagement has divergent effects for students with disabilities.

When thinking about major health concerns in the U.S. and around the world, eye care ranks lower compared to cardiovascular disease, cancer, and diabetes. However, people do not think about the direct connection between diabetes and eye health. Untreated diabetes can lead to visual impairments such as blindness or difficulty seeing. Studies have found that eye health associated with nutrition, occupational exposure, diabetes, high blood pressure, and heart disease are some of the known risk factors. This study aimed to identify the potential risk factors that are associated with visual impairment (VI). The data used for this analysis were obtained from the Centers for Disease Control and Prevention (CDC) - Behavioral Risk Factor Surveillance System (BRFSS) from 2018 to 2021. We found important characteristics, such as the U.S. region, general health perception, employment status, income status, age, and health insurance source, that are associated with VI. Our study confirmed that the common demographical factors including age, race/ethnicity, the U.S. region, and gender are associated with VI. The study also highlights associations with additional risk factors such as health insurance source, general health perceptions, employment status, and income status. Using this information, we can reach out to communities with large numbers of individuals experiencing vision challenges and help educate them on prevention and treatment protocols, thereby effectively addressing VI and blindness challenges within our communities, neighborhoods, and finally, the broader society.

ABSTRACTClimate change jeopardizes human health, global biodiversity, and sustainability of the biosphere. To make reliable predictions about climate change, scientists use Earth system models (ESMs) that integrate physical, chemical, and biological processes occurring on land, the oceans, and the atmosphere. Although critical for catalyzing coupled biogeochemical processes, microorganisms have traditionally been left out of ESMs. Here, we generate a “top 10” list of priorities, opportunities, and challenges for the explicit integration of microorganisms into ESMs. We discuss the need for coarse-graining microbial information into functionally relevant categories, as well as the capacity for microorganisms to rapidly evolve in response to climate-change drivers. Microbiologists are uniquely positioned to collect novel and valuable information necessary for next-generation ESMs, but this requires data harmonization and transdisciplinary collaboration to effectively guide adaptation strategies and mitigation policy.

Quantitative researchers often account for aspects of identity such as race, ethnicity, and disability separately in their analyses. However, scholars have called for a critical approach to these data by disaggregating underserved student groups to better understand the experience of these students. In the current study, we analyzed data from the National Survey of Student Engagement of 16,327 first-year students with disabilities through effect coding, multilevel modeling, and multiple regression analysis to measure engagement patterns related to race and ethnicity. Significant patterns related to the engagement of students of color with disabilities emerged among the dependent variables of "higher-order learning," "student-faculty interaction," and "supportive environment."

Acute mesenteric ischemia (AMI) is a group of diseases characterized by an interruption of the blood supply to varying portions of the intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process may progress to life-threatening intestinal necrosis. The incidence is low, estimated at 0.09-0.2% of all acute surgical admissions, but increases with age. Although the entity is an uncommon cause of abdominal pain, diligence is required because if untreated, mortality remains in the range of 50%. Early diagnosis and timely surgical intervention are the cornerstones of modern treatment to reduce the high mortality associated with this entity. The advent of endovascular approaches in parallel with modern imaging techniques is evolving and provides new treatment options. Lastly, a focused multidisciplinary approach based on early diagnosis and individualized treatment is essential. Thus, we believe that updated guidelines from World Society of Emergency Surgery are warranted, in order to provide the most recent and practical recommendations for diagnosis and treatment of AMI.

BACKGROUND: In 2017, the World Society of Emergency Surgery published its guidelines for the management of adult and pediatric patients with splenic trauma. Several issues regarding the follow-up of patients with splenic injuries treated with NOM remained unsolved. METHODS: Using a modified Delphi method, we sought to explore ongoing areas of controversy in the NOM of splenic trauma and reach a consensus among a group of 48 international experts from five continents (Africa, Europe, Asia, Oceania, America) concerning optimal follow-up strategies in patients with splenic injuries treated with NOM. RESULTS: Consensus was reached on eleven clinical research questions and 28 recommendations with an agreement rate ≥ 80%. Mobilization after 24 h in low-grade splenic trauma patients (WSES Class I, AAST Grades I-II) was suggested, while in patients with high-grade splenic injuries (WSES Classes II-III, AAST Grades III-V), if no other contraindications to early mobilization exist, safe mobilization of the patient when three successive hemoglobins 8 h apart after the first are within 10% of each other was considered safe according to the panel. The panel suggests adult patients to be admitted to hospital for 1 day (for low-grade splenic injuries-WSES Class I, AAST Grades I-II) to 3 days (for high-grade splenic injuries-WSES Classes II-III, AAST Grades III-V), with those with high-grade injuries requiring admission to a monitored setting. In the absence of specific complications, the panel suggests DVT and VTE prophylaxis with LMWH to be started within 48-72 h from hospital admission. The panel suggests splenic artery embolization (SAE) as the first-line intervention in patients with hemodynamic stability and arterial blush on CT scan, irrespective of injury grade. Regarding patients with WSES Class II blunt splenic injuries (AAST Grade III) without contrast extravasation, a low threshold for SAE has been suggested in the presence of risk factors for NOM failure. The panel also suggested angiography and eventual SAE in all hemodynamically stable adult patients with WSES Class III injuries (AAST Grades IV-V), even in the absence of CT blush, especially when concomitant surgery that requires change of position is needed. Follow-up imaging with contrast-enhanced ultrasound/CT scan in 48-72 h post-admission of trauma in splenic injuries WSES Class II (AAST Grade III) or higher treated with NOM was considered the best strategy for timely detection of vascular complications. CONCLUSION: This consensus document could help guide future prospective studies aiming at validating the suggested strategies through the implementation of prospective trauma databases and the subsequent production of internationally endorsed guidelines on the issue.

BACKGROUND: Non-traumatic emergency general surgery involves a heterogeneous population that may present with several underlying diseases. Timeous emergency surgical treatment should be supplemented with high-quality perioperative care, ideally performed by multidisciplinary teams trained to identify and handle complex postoperative courses. Uncontrolled or poorly controlled acute postoperative pain may result in significant complications. While pain management after elective surgery has been standardized in perioperative pathways, the traditional perioperative treatment of patients undergoing emergency surgery is often a haphazard practice. The present recommended pain management guidelines are for pain management after non-traumatic emergency surgical intervention. It is meant to provide clinicians a list of indications to prescribe the optimal analgesics even in the absence of a multidisciplinary pain team. MATERIAL AND METHODS: An international expert panel discussed the different issues in subsequent rounds. Four international recognized scientific societies: World Society of Emergency Surgery (WSES), Global Alliance for Infection in Surgery (GAIS), Italian Society of Anesthesia, Analgesia Intensive Care (SIAARTI), and American Association for the Surgery of Trauma (AAST), endorsed the project and approved the final manuscript. CONCLUSION: Dealing with acute postoperative pain in the emergency abdominal surgery setting is complex, requires special attention, and should be multidisciplinary. Several tools are available, and their combination is mandatory whenever is possible. Analgesic approach to the various situations and conditions should be patient based and tailored according to procedure, pathology, age, response, and available expertise. A better understanding of the patho-mechanisms of postoperative pain for short- and long-term outcomes is necessary to improve prophylactic and treatment strategies.

The present study examined the relationship between perceived uncertainty and depression/ anxiety symptoms during the COVID-19 pandemic and it tested the moderating roles of resilience and perceived social support in this relationship. A cross-sectional study was conducted between March 31st and May 15th, 2020, using an online, multi-language, international survey built within Qualtrics. We collected data on sociodemographic features, perceived uncertainty, perceived social support, depression and anxiety symptoms, and resilience. A moderation model was tested using model 2 of Hayes' PROCESS macro for SPSS. The study included 3786 respondents from 94 different countries, 47.7% of whom reported residence in the United States of America. Results demonstrated that higher perceived uncertainty was associated with more symptoms of depression and anxiety. Higher resilience levels and higher perceived social support were associated with fewer depression and anxiety symptoms. The moderation hypotheses were supported; the relationship between uncertainty and symptoms of depression and anxiety decreased as levels of resilience increased and as perceived social support increased. The results suggest that resilience and social support could be helpful targets to reduce the negative effects of uncertainty on depression and anxiety symptoms., Author(s): Arwa Ben Salah [sup.1] , Briana N. DeAngelis [sup.2] , Mustafa al'Absi [sup.2] Author Affiliations: (1) grid.411838.7, 0000 0004 0593 5040, Community Medicine Department, Faculty of Medicine of Monastir, [...]

Abstract We conducted a genome-wide association study (GWAS) in a multiethnic cohort of 920 at-risk infants for retinopathy of prematurity (ROP), a major cause of childhood blindness, identifying 1 locus at genome-wide significance level (p